Ngatidzidzei nezvechirwere ichi chisingawanzoitiki mumoyo wemwana wenyu? (Interrupted Aortic Arch)

Kuunza mwana achangoberekwa kumba chiitiko chinofadza mhuri. Asi panguva imwe chete, zvinogonawo kuunza kutya kuvabereki. "Mwana ari kufamba zvakanaka here?", "Mwana ari kufema zvakanaka here?", "Sei achichema zvakanyanya?" Ungave wakambova nemibvunzo yakaita seiyi. Kunyange zvazvo kazhinji izvi zviri zvinhu zvakajairika, dzimwe nguva pane mamiriro ezvinhu asingawanzoitiki anoda kuti tinyatsochenjerera. Nhasi tichataura nezvechirwere chemwoyo chisingawanzoitiki chinogona kuitika muvana vacheche, asi chinoda kurapwa nekukasika. Izvozvo zvinoreva Interrupted Aortic Arch, kana kuti IAA muchidimbu.

Zvichitaurwa zviri nyore, chii chinonzi Interrupted Aortic Arch (IAA)?

Kuti tinzwisise izvi, ngatitangei tatarisa mashandiro anoita mwoyo wedu. Fungidzira kuti moyo wako ipombi huru yemvura ine makamuri mana.

• Dzimba mbiri dzepamusoro (Atria): Ropa re "bhuruu" risina mweya rinobva mumuviri rinopinda mukamuri imwe, uye ropa "dzvuku" rakaiswa mweya rinobva mumapapu rinopinda mune imwe.
• Makamuri maviri epasi (ventricles): Aya ndiwo makamuri makuru ekupomba. Kune rimwe divi, anotumira ropa risina oxygen kumapapu kuti aritore. Kune rimwe divi, anopomba ropa dzvuku rine oxygen yakawanda kuti riparadzirwe mumuviri wese.

Tsinga huru yeropa inotakura ropa rine oxygen mumuviri wese inonzi Aorta . Inowanzo umbwa setsvimbo, kana kuti arch.

Zvino, panyaya yeInterrupted Aortic Arch (IAA) , arch yeaorta haina kukwana. Zvakafanana nepombi huru inotakura mvura kubva mutangi remvura kuenda kumba yese yakatsemuka kuita zvikamu zviviri . Nekuda kweizvi, zvisinei nekuti mwoyo unopomba zvakaoma sei, haugone kutumira ropa rine oxygen yakawanda kuzvikamu zvepasi zvemuviri. Ichi chirwere chakakomba zvikuru, chinoisa hupenyu panjodzi . Nekuti kana zvikamu zvemuviri zvikasawana ropa, nhengo idzodzo dzinogona kutadza uye dzingave nenjodzi huru kumwana.

Unoziva sei kana mwana wako aine chirwere ichi? Ndezvipi zviratidzo zvacho?

Mwana ane IAA anowanzo ratidza zviratidzo mukati memazuva mashoma ekutanga mushure mekuzvarwa. Izvi zvinodaro nekuti moyo wemwana usati waberekwa, unowana mweya wekufema kubva mumuviri waamai, izvo zvisiri dambudziko, asi mushure mekuzvarwa, moyo wemwana unofanirwa kushanda wega. Ndipo panotanga dambudziko iri.

Unofanira kungwarira zvikuru nezvezviratidzo zvinotevera.

Kana ukaona chimwe chezviratidzo izvi, enda kuna chiremba nekukurumidza. Kana zvichidikanwa, endesa mwana wako kuEmergency Treatment Unit (ETU) yechipatara chiri pedyo.

Zvimwe zvikanganiso zvemoyo zvinogona kuitika nechirwere ichi

Vacheche vane IAA vanogona kunge vaine zvimwe zvirema zvemoyo panguva imwe chete.

• Chirema cheVentricular Septal (VSD): Iri iburi riri pamadziro pakati pemakamuri maviri epasi ekupomba (ventricles) emwoyo. Zvinoshamisa kuti kuva neVSD dzimwe nguva kunogona kubatsira kwenguva pfupi kana paine IAA, sezvo zvichiita kuti ropa rine oxygen ripfuure nepaburi richienda mumuviri.
• Atrial Septal Defect (ASD): Iri iburi riri pamadziro pakati pemakamuri maviri epamusoro emoyo.
• Truncus Arteriosus: Apa ndipo panosangana tsinga mbiri huru dzeropa dzinobuda mumoyo (aorta nepulmonary artery) kuti dziumbe imwe chete.

Sei izvi zvichiitika kuvana vacheche? Chikonzero chacho ndechei?

Sevabereki, mubvunzo wekutanga unouya mupfungwa dzenyu pamunonzwa izvi ndewekuti, "Iyi imhosva yedu here?" Ehe kwete.

Interrupted Aortic Arch (IAA) chirwere chinokonzerwa nekusakwana kwemajini . Zvichitaurwa zviri nyore, machromosome edu ndiwo 'bhuku' rine mirairo yese yekuvakwa kwemiviri yedu. Mumamiriro ezvinhu aya, chidimbu chidiki chechromosome chine mirairo yekuvakwa kwemwoyo netsinga dzeropa hachina. Izvi zvinoita kuti aorta isaumbwe zvakanaka.

Kazhinji, vacheche vane IAA vanewo chimwe chirwere chemajini chinonzi DiGeorge syndrome . Izvi zvinokonzerwawo nekushaikwa kwechikamu chechromosome imwe chete. Vana vane DiGeorge syndrome vanogona kunge vaine hutachiona kakawanda uye shanduko dzakasiyana dzechiso (senge cleft lip).

Vanachiremba vanowana sei izvi chaizvo?

Kana ukaenda nemwana wako kuchipatara, kana vanachiremba vakaongorora mwana uye vakafungidzira kuti ane chirwere chemwoyo chakadai, bvunzo huru yekusimbisa i echocardiogram .

Dzimwe nguva, chirwere chemwoyo chakadai chinogona kuonekwa panguva yekuongorora zvinhu zvisina kujairika (ultrasound scan) mwana achiri mudumbu.

Ndeapi marapirwo eizvi? Mwana anogona kurapwa here?

Ehe, zvechokwadi. Kunyangwe ichi chiri chirwere chakakomba, chinogona kurapwa zvachose nekuvhiyiwa . Maitiro ekurapa anogona kukamurwa kuita zvikamu zvikuru zviviri.

1. Zvekuita nguva pfupi usati wavhiyiwa

Mushure mekuongororwa, mwana anoendeswa kuchipatara chevana vacheche (NICU). Chinangwa chikuru ndechekuchengetedza ropa richiyerera mumuviri kusvika mwana agadzirira kuvhiyiwa.

Vanachiremba vanoshandisa nzira yekuchenjera kuita izvi. Mwana wese asati aberekwa, panenge paine kubatana kwenguva pfupi (ductus arteriosus) pakati peaorta netsinga inotakura ropa kuenda kumapapu. Izvi zvinovhara zvega mukati memaawa mashoma kana mazuva mushure mekuzvarwa.

Asi mumamiriro ezvinhu eIAA, vanachiremba havabvumiri kubatana uku kwenguva pfupi. Zvakafanana ne 'bypass' inoshandiswa kana mugwagwa mukuru wakavharwa. Chengeta nzira iyi yekupfuura yakavhurika.Mushonga unonzi Prostaglandin E1 unopiwa mwana mumunyu. Izvi zvinoita kuti muviri wemwana wepazasi upihwe ropa kusvika pakuvhiyiwa.

2. Kuvhiyiwa kunoponesa hupenyu

Kana mamiriro emwana agadzikana, kuvhiyiwa uku kunoitwa nevana vanovhiya mwoyo.

• Chinhu chikuru: Zvikamu zviviri zveaorta zvakachekwa uye zvakaparadzaniswa zvinobatanidzwazve, zvichiita kuti pave ne arch yakakwana.
• Zvimwe zvinhu: Panguva imwe chete, kana mwana aine VSD (buri riri mumoyo), richavharwawo panguva yekuvhiyiwa uku. Nzira yekubvisa dumbu (PDA) yakavhurwa nemishonga kare ichavharwawo, nekuti ikozvino nzira huru yapera, hapana chikonzero chekuivhara.

Uku kuvhiyiwa kwakaoma zvikuru, asi vanachiremba vane hunyanzvi muSri Lanka vanovhiya zvakadaro zvinobudirira.

Ramangwana remwana richave rakaita sei mushure mekuvhiyiwa?

Ichi ndicho chinhu chinonyanya kukosha. Mushure mekuvhiyiwa kwakabudirira, vana vazhinji vanogona kurarama hupenyu hwakanaka uye hwakanaka . Zvichienderana nehuwandu, kunyangwe makore gumi mushure mekuvhiyiwa, vanhu vanopfuura 81% vachiri vapenyu.

Asi chinhu chakakosha kurangarira ndechekuti kunyangwe mushure mekuvhiyiwa, unofanirwa kugara uchiongororwa nachiremba wemwoyo kweupenyu hwako hwese . Unofanira kuenda kumakiriniki panguva yakatarwa uye kuongororwa se echocardiogram kuti uone kana moyo wako uchishanda zvakanaka. Dzimwe nguva, kana wakura, ungangoda kurapwa zvakare. Saka, zvakakosha kutevedzera mirairo yachiremba wako.

Zvakajairika kunzwa sekunge nyika yako yese yaparara paunoona kuti mwana wako ane chirwere ichi. Asi yeuka, sainzi yezvekurapa yafambira mberi zvikuru nhasi. Kana chirwere ichi chikaonekwa nekukurumidza uye chikarapwa nemazvo, mwana wako ane mukana wakanaka wekufara sevamwe vana vese.